Organization
METRO INFECTIOUS DISEASE CONSULTANTS, LLC
Active
Other names
MIDC, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TARA KOWALSKI (CREDENTIALING MANAGER)
(888) 220-6432
Entity
Organization
Contact information
Practice address
13657 W MCDOWELL RD, SUITE 118, GOODYEAR, AZ 85395-2601
(623) 328-7794
(623) 328-7932
Mailing address
901 MCCLINTOCK DR, SUITE 202, BURR RIDGE, IL 60527-0871
(888) 220-6432
(630) 734-4715
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
—
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
780223
—
AZ
Enumeration date
03/06/2013
Last updated
07/21/2022
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